Provider Demographics
NPI:1497735021
Name:DUPREE, THERESE M (PTA)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:M
Last Name:DUPREE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1663 FALMOUTH ROAD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02632-2944
Mailing Address - Country:US
Mailing Address - Phone:508-775-9200
Mailing Address - Fax:508-815-4919
Practice Address - Street 1:1663 FALMOUTH ROAD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02632-2944
Practice Address - Country:US
Practice Address - Phone:508-775-9200
Practice Address - Fax:508-815-4919
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8215225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant